脂联素的血管及心肌保护作用

脂联素是由脂肪细胞分泌的一种内源性生物活性多肽.多项研究结果表明,脂联素具有抗炎、抗动脉粥样硬化、抑制新生血管、抗氧化应激及调节能量代谢等心血管保护作用.流行病学调查亦显示:在一些肥胖相关疾病的患者体内,脂联素水平的降低与心血管疾病风险增加相关.脂联素的作用机制复杂,与多种信号转导通路有关.脂联素有望为糖尿病心血管疾病...     

脂联素抵抗研究进展

脂联素与脂联素受体结合,经多种信号转导途径发挥改善胰岛素抵抗、调节糖脂代谢、负性调控炎性反应以及拮抗动脉粥样硬化的作用.一些病理牛理过程中脂联素水平升高,但没有显著保护性效应,提示存在脂联素抵抗.脂联素抵抗的机制包括脂联素聚合能力改变、脂联素受体(AdipoRs)表达减少及脂联素受体后AMP活化蛋白激酶(AMPK)、过氧化物酶体增殖物活化受体(PPAR)α等信号通路转导障碍.高血糖、肥胖、胰岛素抵抗等与脂联素抵抗密切相关,可以互为因果,形成恶性循环.     

瘦素和脂联素在慢性肝病中的研究进展

瘦素、脂联素是新发现的重要脂肪因子.近年来瘦素、脂联素在NAFLD、丙肝及肝硬化等慢性肝病中的作用已引起众多学者的关注,多数研究发现在非酒精性脂肪肝和丙肝患者中血清瘦素水平增高而脂联素水平降低,而这些脂肪因子在慢性肝痛发生发展中的作用还未完全阐明,各家报道不一.本文就瘦素、脂联素与慢性肝病的研究进展作一综述.     

脂联素对心力衰竭影响的研究进展

脂联素是一种脂肪源性细胞因子,对心血管系统有保护作用.然而,近年来研究却发现,循环中增高的脂联素是心力衰竭患者死亡的独立预测因子,其机制尚不清楚.脂联素对心力衰竭的作用是否受到某些生物标记物、药物、合并症等诸因素的影响也有待研究.     

脂联素在非酒精性脂肪肝中的作用及机制

脂联素是由脂肪细胞分泌的胰岛素敏感性脂肪因子,其对非酒精性脂肪肝病(NAFLD)有多种有益作用.在循环中脂联素有3种低聚亚型,包括三聚体、六聚体及高分子量低聚复合物.脂联素通过与靶器官上脂联素受体结合来发挥效应,其保肝作用已经在临床和实验室研究中证明.脂联素的下降是NAFLD及肝脏功能损害的独立危险因素.在动物实验中,通过药物或基因疗法使循环中的脂联素增高可导致肝肿大、脂肪变、坏死炎症及其相关肝脏疾病.脂联素敲除的小鼠,会发生肝脂肪变和线粒体功能损害,这致使小鼠易于遭受脂肪肝病的二次打击.本文旨在综述近年来对于脂联素在NAFLD中的保肝作用及机制的研究成果.     

脂联素与临床相关疾病的研究进展

目的 综述脂联素与临床相关疾病的最新研究进展.方法 通过文献检索收集有关脂联素的资料并进行综述.结果 关于脂联素与临床相关疾病的研究比较热门.结论 脂联素是临床相关疾病的生物指标,在临床相关疾病的研究和防治中具有重要作用.     

脂联素生物学与消化系统肿瘤

脂联素是由脂肪细胞分泌的一种蛋白,具有增加胰岛素敏感性、抗炎、抗动脉硬化、抑制细胞增殖等作用。近年研究表明,脂联素可抑制多种消化系统肿瘤细胞生长,其在肿瘤发生和发展过程中发挥重要作用。然而脂联素在肿瘤演变过程中的作用机制尚未完全明确。本文就脂联素生物学、脂联素及其受体在消化系统肿瘤发生、发展中的作用及其临床意义作一综述。     

球状脂联素抑制波动性高血糖诱导人脐静脉内皮细胞凋亡与脂联素受体1有关

目的 探讨球状脂联素在抑制波动性高血糖诱导人脐静脉内皮细胞凋亡中的机制.方法 不同条件下体外培养人脐静脉内皮细胞5天.实验分为对照组(葡萄糖5.5 mmol/L)、高糖组(葡萄糖25 mmol/L)、葡萄糖交替组(葡萄糖5.5/25 mmol/L,每8 h更换培养液一次)、高渗组(甘露醇25 mmol/L)和高渗交替组(甘露醇5.5/25 mmol/L,每8 h更换培养液一次).葡萄糖交替组中部分细胞用不同浓度(0、0.5、1.0和3 mg/L)球状脂联素干预,用脂联素受体1特异性小干扰RNA作用内皮细胞.采用流式细胞仪检测细胞凋亡及RT-PCR检测脂联素受体1和受体2 的mRNA表达.结果 与对照组比较,高糖组和葡萄糖交替组细胞凋亡明显增加,脂联素受体1 mRNA的表达显著降低(P<0.01).与高糖组比较,葡萄糖交替组细胞凋亡显著增加,脂联素受体1 mRNA的表达显著降低(P<0.01).不同浓度(0、0.5、1.0和3 mg/L)球状脂联素作用内皮细胞,发现3 mg/L球状脂联素能显著抑制内皮细胞凋亡(P<0.01),并能显著拮抗波动性高血糖诱导的脂联素受体1 mRNA表达的下降(P<0.01).不同组间内皮细胞脂联素受体2 mRNA表达差异无显著性.siRNA作用内皮细胞后球状脂联素这种抑制凋亡作用显著减弱(P<0.01).结论 与持续性高血糖条件比较,波动性高血糖显著降低人脐静脉内皮细胞脂联素受体1 mRNA的表达,而对脂联素受体2 mRNA的表达无影响.球状脂联素可能通过脂联素受体1拮抗波动性高血糖诱导的人脐静脉内皮细胞凋亡.     

脂联素：心血管疾病新的危险预测因子

脂联素是脂肪组织特异性分泌的一种激素蛋白,众多研究表明其具有抗动脉粥样硬化、抗炎、改善胰岛素抵抗等作用.在冠心病、胰岛素抵抗、高脂血症、2型糖尿病和肥胖等疾病及存在胰岛素抵抗的病人中,脂联素水平明显下降,低脂联素可作为动脉粥样硬化的新型危险因子,同时是代谢综合征的独立危险因子和生物标记,高脂联素血症可能是充血性心力衰竭一个独立的预后预测因子.脂联素水平越高其预后越差.现综述了现阶段脂联素与心血管代谢疾病的最新研究进展.     

女性骨关节炎患者血浆和关节液瘦素与脂联素水平及相关分析

目的 研究女性骨关节炎患者血浆和关节液中瘦素和脂联素的水平.方法 测定26例患者血浆和关节液中瘦素和脂联素,以及关节液中蛋白聚糖的降解片段.结果 关节液瘦素和脂联素均低于其血浆水平,且与其血浆水平均无明显相关,关节液脂联素与蛋白聚糖降解片段正相关.结论 瘦素和脂联素可能通过局部作用参与OA代谢通路.     

Viral hepatitis: Past,present, and future

Each hepatitis virus—Hepatitis A, B, C, D, E, and G—poses a distinct scenario to the patient and clinician alike. Since the discovery of each virus, extensive knowledge regarding epidemiology, virologic properties, and the natural clinical and immunologic history of acute and chronic infections has been generated. Basic discoveries about host immunologic responses to acute and chronic viral infections, combined with virologic data, has led to vaccines to prevent Hepatitis A, B, and E and highly efficacious antivirals for Hepatitis B and C. These therapeutic breakthroughs are transforming the fields of hepatology, transplant medicine in general, and public and global health. Most notably, there is even an ambitious global effort to eliminate chronic viral hepatitis within the next decade. While attainable, there are many barriers to this goal that are being actively investigated in basic and clinical labs on the local, national, and international scales. Herein, we discuss pertinent clinical information and recent organizational guidelines for each of the individual hepatitis viruses while also synthesizing this information with the latest research to focus on exciting future directions for each virus.     

急性非甲乙丙丁戊型病毒性肝炎的临床分析

本文对４３例未定型病毒性肝炎患者的流行病学资料、临床表现等进行了分析。结果表明：本组患者起病急，常有短暂发热、消化道症状、黄疸、肝大。在同期住院的急性病毒性肝炎中占１２．４６％。发病时间以冬末及春季为多见，中、老年病人占相当比例。本组患者皮疹，关节痛等血清病样表现极少见，其ＡＬＴ活性及ＳＢ多明显增高，除２例因亚急性重型肝炎死亡外，其余病例都在１个月左右顺利康复，与文献中提及的己、庚型病毒性肝炎的临     

From hepatitis A to E: A critical review of viral hepatitis

Viral infections affecting the liver have had an important impact on humanity, as they have led to significant morbidity and mortality in patients with acute and chronic infections. Once an unknown etiology, the discovery of the viral agents triggered interest of the scientific community to establish the pathogenesis and diagnostic modalities to identify the affected population. With the rapid scientific and technological advances in the last centuries, controlling and even curing the infections became a possibility, with a large focus on preventive medicine through vaccination. Hence, a comprehensive understanding of hepatitis A, B, C, D and E is required by primary care physicians and gastroenterologists to provide care to these patients. The review article describes the epidemiology, pathogenesis, clinical presentation, diagnostic tools and current medication regimens, with a focus on upcoming treatment options and the role of liver transplantation.     

Viral hepatitis in 2021:The challenges remaining and how we should tackle them

Viral hepatitis results in 1.4 million deaths annually.The World Health Organization(WHO)set an ambitious target to eliminate viral hepatitis by 2030,but significant challenges remain.These include inequalities in access to healthcare,reaching at risk populations and providing access to screening and effective treatment.Stigma around viral hepatitis persists and must be addressed.The WHO goal of global elimination by 2030 is a worthy aim,but remains ambitious and the coronavirus 2019 pandemic undoubtedly has set back progress.This review article will focus on hepatitis A to E,highlighting problems that have been resolved in the field over the past decade,those that remain to be resolved and suggest directions for future problem solving and research.     

HDV感染后乙型肝炎患者血清肝炎病毒标志物的变化

目的　分析HDV感染患者血清病毒性肝炎标志物的变化和意义 ,探讨HDV致病机理。方法　对 469例HDV阳性乙型肝炎患者常见各类型病毒性肝炎血清标志物的变化等作统计分析 ,以 2 13例HDV( -)乙型肝炎患者作对照。结果　HDV感染后血清HBeAg检出率降低 (P <0 .0 1)。在HDV ( +)HBVDNA( -)组 ,HBeAg( -)的机会大 (P <0 .0 1)。在急性肝炎、重型肝炎和肝硬化患者HDAg( +)HBeAg( -)为主要血清病毒表现形式 (P <0 .0 1或 0 .0 5 )。HDV感染后合并其它肝炎病毒感染率高于乙型肝炎组。结论　HDV感染可抑制HBV复制或HBeAg表达 ,混合感染HDV的乙型肝炎中HDV的直接细胞毒性作用可能起主要致病作用。重叠感染HDV的乙型肝炎患者其病情重、病死率高和容易慢性化。     

临床肝病患者中庚型肝炎病毒(GBV-C/HGV)的感染

本文应用抗-HGV酶联免疫法(EIA)和逆转录套式聚合酶链反应法(RT-PCR)检测150份乙型、120份丙型、15份戊型和49份非甲-戊型肝炎患者血清。结果显示:乙肝、丙肝、戊肝和非甲-戊型肝炎患者中抗-HGV抗体的阳性率分别为22.0％(33/150)、25.0％(30/120)、33.3％(5/15)和40.1％(20/49)。其中乙型、丙型、戊型和非甲-戊型肝炎的抗-HGV抗体阳性者中,HGV RNA的阳性率分别为58.3％(7/12)、60.0％(6/10)、40.0％(2/5)和45.5％(9/12)。说明GBV-C/HGV可与HBV、HCV或HEV合并感染,该病毒可能引起临床型肝炎。     

Sustained Virological Response in Chronic Hepatitis C Patients after a 6- and a 36-Month Interferon-a2b Treatment Schedule. A Multicenter,Randomized, Controlled Study

With the introduction of medical treatment (chenodeoxycholic acid therapy) of cholesterol gallstones, the prediction of the gallstone type, cholesterol — non-cholesterol stones (i.e. cholesterol predominating or not), has become important. In 24 consecutive patients admitted for surgery because of gallstones, the value of various criteria for differentiation between the two types of stones was assessed. It is concluded that the combined requirements of radiolucency of the stones and a cholesterol saturation index in duodenal bile above 1.00 constitutes a fairly reliable method for selection of patients for dissolution therapy with chenodeoxycholic acid.     

铜相关蛋白和组织铁在丙型、丁型、庚型肝炎肝组织中的定位比较

目的 研究铜相关蛋白(C-AP)和组织铁(IT)在丙型肝炎,丁型肝炎和庚型肝炎中的变化特点。方法应用改良的Shikata和Berlin blue方法,检测三种肝炎患者肝穿活检组织中的C-AP和IT的定位及分级程度。结果 C-AP和IT的阳性率和分级程度随着肝组织损伤的严重程度而递增。在三种肝炎肝组织中,C-AP和IT的阳性率及分级程度有明显差异。结论 C-AP和IT可以反映出三种病毒性肝炎肝组织损伤的差异,庚型肝炎肝组织损伤比丙型肝炎和丁型肝炎肝组织损伤轻。     

Health Related Quality of Life in Iranian Hemodialysis Patients With Viral Hepatitis: Changing Epidemiology

Background

There are surprisingly a few studies that evaluate the impact of chronic viral hepatitis, which is common in HD (hemodialysis) patients, on HRQOL (health related quality of life).

Objectives

We conducted a study to evaluate the impact of chronic viral hepatitis on HRQOL and to compare their HRQOL with non-infected HD patients via a HRQOL questionnaire.

Patients and Methods

The Iranian adapted version of the Kidney Disease Quality of Life Short Form (KDQOL-SF) version 1.3 questionnaires were filled out by the HD patients. In all HD patients, serum HBsAg, HBS Abs, and HCV Abs [enzyme-linked immunosorbant assay (ELISA)] were routinely checked every six months. Patients were considered to have chronic HBV infection if HBsAg was positive for more than six months. In all HD patients, third generation assay was used to detect HCV infection. Furthermore, serum HCV-RNA (PCR) was examined in anti-HCV-positive patients for confirmation of HCV infection.

Results

in this cross sectional study 4101 patients from 103 dialysis units in Iran between October 2010 and August 2011 were included. Prevalence of hepatitis B and hepatitis C infection was 2.1% and 1.3% respectively. Almost all KDQOL items for viral hepatitis patients had equivalent or better scores than those without viral hepatitis. In the logistic regression after adjustment for age, sex, educational level, marital status, dialysis vintage, HBs Ag positivity and HCV Ab positivity, only age (P < 0.001) and educational level (P = 0.015) had negative impact on quality of life.

Conclusions

Our data show that not only general health and physical activity were preserved but also health perception may be better among HD patients with viral hepatitis.